Insurance for Mini Med Pump Supplies

[TEXSONMOM]

Last year my son met the DME max on my insurance with the Minimed pump and CGMS purchase.

Now I am getting bills from Minimed from last year because my insurance said I met the DME max in 2007. They are considering the supplies as DME. Does anyone have any experience in convincing an insurance company that the supplies should be considered something other than DME? In my mind they are the same as syringes - something that is throwaway to deliver insulin.

Thanks for your help. I have a pretty forgiving PPO plan but I am afraid sometimes to ask them something and end up having them go back and change something to my negative.

Anyone have any helpful ideas?

[iluvmhp]

No advise, but we are in the same situation. Pump and all supplies are considered DME and we have a 2500 cap.

[Abby-Dabby-Doo]

I would encourage you to look up your state laws. Some states are fighting, stating insurance can't put a cap on DME. I apologize but I don't remember the state that is fighting it, and the states that have put a law against it. I want to say California maybe?!
I would do a little internet searching.
Good luck! It's not right!!!
Maybe fight it with an insurance appeal?! Fight that your son goes through more DME due to his age. Kids sweat, are more active, swim, bath, rugged where sites get yanked out, sick (due to being around more kids), and so forth A LOT more than adults, which in my opinion means more supplies.